• 유통과학연구
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• 제10권4호
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• pp.13-20
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• 2012

유동근무제는 고정된 시간대에만 근무하지 않고 조직과 종업원의 협의에 의하여 근무시간대를 유연하게 조절하는 제도를 의미한다. 대부분의 선행연구에서는 유동근무제가 성과나 생산성, 조직에 대한 태도, 결근율 및 이직률에 미치는 영향을 밝히는데 그 초점을 맞추었으나, 한국의 대부분 기업들이 아직 이 제도를 채택하지 않기 때문에 본 연구는 서울에 주소지를 둔 유통업체에 종사하는 노동자들을 대상으로 현장조사를 실시하여 노동자들의 개인적 특성이 유동근무제의 선호성향에 미치는 영향을 분석함으로써 제도도입을 위한 이론적 틀을 제공하는데 그 목적을 두고 있다. 본 연구의 결과를 요약하면 다음과 같다. 노동자들의 연령은 유동근무제의 선호성향에 영향을 미치지 않는 것으로 나타났다. 다만 통계적으로 유의하지는 않았지만 36세 이상의 노동자들은 35세 미만의 노동자들에 비해 선호성향이 낮은 것으로 나타났다. 남성의 선호성향이 여성보다 더 높게 나타났는데, 이것 역시 유동근무제는 자기개발과 직장생활을 공존하게 할 수 있어 아무래도 자기개발에 관심이 적은 여성보다는 남성들의 태도가 더 호의적인 것으로 분석되고 있다. 통제의 위치와 유동근무제에 대한 선호성향은 약한 상관관계가 존재하는 것으로 나타났는데 이것은 내적 통제를 지향하는 노동자일수록 유동근무제에 대해 호의적인 태도를 갖고 있음을 의미한다. 성취욕구가 높은 노동자일수록 유동근무제에 대해 호의적인 태도를 보여줬다. 성취욕구가 높은 사람들은 새로운 제도를 도입하는데 있어서 과감하게 도전을 하기 때문으로 보인다. 직무만족과 유동근무제의 선호성향과는 유의한 관련성을 나타내고 있지 않았다. 끝으로 본 연구의 한계를 제시하고 향후 연구의 방향을 제시한다.

• 한국간호교육학회지
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• 제2권
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• pp.75-94
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• 1996

This survey study was aimed at identifying the degree of educational need of the KNOU(Korea National Open University) nursing students defined as admission purposes, satisfaction of distance learning education, learning methods, and courses after graduation. Among randomly assigned 1000 students, 320 KNOU nursing students who allowed to participate in the study completed the questionnaires. The data were analyzed using descriptive statistics, chi-square test, and t-test, Results of this study were as follows : 1. The admission purposes of the KNOU nursing students were 'in order to get a bachelor's degree(83.8%)', 'to acquire knowledge for task(61.3%)', or 'to be admitted for the graduate school (53.1%)' etc. Comparing the admission purposes by age, tow items- 'to explore new possibilities for myself' and 'excellent curriculum' showed statistically significant differences. These two items were also found to show significant differences by marital status. 2. For the media maintenance, the results showed that students use their own cassett radios(96.3%), VTR(49.4%), TV only for the study (44.1%), personal computer (3.31%), or joining Hitel (6.3%). 3. Listening rates of the radio lecture were 'over 80%(9.1%)', '50-80%(9.1%)', '20-50%(18.1%)', 'below 20%(30%)' and 'never(33.1%)', And record lecture showed listening rates as follows : 'over80%(17.2%)', '50-80%(15.9%)', '20-50%(24.4%)', 'below 20%(27,2%)' and 'never(14.4%)'. 4. The difficulties with KNOU life were 'listening radio lectures(38.8%)', studying by following teaching schedules (37.8%)', 'isolated self-study(10.3%)', and 'appearance in the attending classes(8.1%)'. 5. As for satisfaction with teaching methods, the data showed that 81.2% of the respondents were satisfied (or very satisfied) with 'attending classes' and 75%, with 'paper lectures'. On the other hand some of respondents were very dissatisfied with 'recorded lecture(12.8%)' and 'radio lecture(10.9%)' 6. The results also showed that the students want to have 'video conferencing lecture(77.2%)', 'cable TV(64.1%)' and 'CD ROM program' to improve learning effects. 7. Concerning learning attitudes, 48.8% of the students reported 'study mainly for examnination', and only 4.1% answered 'study every day with plan'. The learning attitude showed significant differences by marital status and age. The students also evaluated themelves as 'study very hard(5.9%)', 'study hard in general(41.6%)', 'study a little(40.3%)' and 'study little(11.9%)'. 8. The students responded the most effective learning material was the 'textbook (92.2%)'. 9. For the purposes of using the local center, the results showed 'for the attending classes(76.3%)', 'for the use of references(14.7%)', and 'for the study group(66.7%)'. 10. The results revealed that 20.3% of the respondents had ever experienced unregistration or temporary withdrawal, and 53.4% among them did not register more than one time. The most common reason for the unregistration was 'due to family affairs or their job (70.8%)'. 11. 88.1% of the respondents answered 'they will graduate without fail'. 12. Regarding the benefits from the KNOU graduation, respondents indicated 'graduate school admission(38.1%)', 'self-confidence in social life(17.5%)', and understanding social problems (10.9%)'. 13. 64.4% of the students showed that they have intention to enter the graduate school. The item 'changing work place' showed statistically significant differences by marital status and age.

• 한국치위생학회지
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• 제7권2호
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• pp.135-151
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• 2007

The purpose of this study was to examine the work environments of dental hygienists, to find out about what problems there were with their work environments and ultimately to help improve their work environments. It's basically intended to pave the way for furthering the welfare and interests of dental hygienists. The subjects in this study were dental hygienists who were selected by random sampling from among the members of Korean Dental Hygienists Association. Approximately 20 percent of the members each were selected from every region across the nation, and their work environments were investigated in consideration of the kind of their workplaces, service area, career and field of duties. As for the demographic characteristics of the dental hygienists investigated, there were differences between those who worked in the field of health care and the clinical workers. More of the former were older and married, and the former was ahead of the latter in career and education as well. Regarding working hours and leave of absence by kind of workplace, the number of regular average holidays was different according to their place of employment. Dental hospitals(6.66 days) and dental clinics(6.81 days) gave their employees less days off on the whole, whereas public dental clinics(19.29 days) granted the dental hygienists the longest leave of absence. Also, there was a broad gap in the number of regular average holidays among different regions in the nation. The dental hygienists who worked in Gangweon province enjoyed the longest holidays(10.88 days), while those on Jeju Island took the shortest vacation(4.46 days). Concerning monthly mean pay by place of employment, those who worked in public dental clinics were paid the best, and the dental hospital employees received the smallest pay. Their monthly mean pay significantly varied with the kind of their workplaces. As to connections between service area and pay level in the event of the dental hygienists with a four-year career, those who served in Seoul were paid the best(1,820,800 won), followed by Gyeonggi province(1,795,800 won), Gyeongsang province(1,604,200 won), metropolitan cities(1,424,800), Gangweon province(1,300,000 won) and Jeolla province(1,016,700 won). In regard to the starting pay in the different areas, the starting pay was largest in Seoul(1,501,800 won) and smallest in Jeolla province(904,000 won). Concerning work environments by place of employment, the dental hygienists in public dental clinics, general hospitals and university hospitals were far older than the others, and the career of the former was much larger than that of the latter. As to the number of regular leave of absence, public dental clinics, general hospitals and university hospitals were different from dental hospitals and clinics in that regard as well. Concerning monthly pay, public dental clinics paid their employees the best, and dental hospitals and clinics were ahead in terms of pay raise. But the reason seemed that public dental clinics and general hospitals increased the pay of their employees based on a fixed wage system and according to a fixed rate at the same time. As for relations between career and work environments, the pay of the dental hygienists differed with their career. The amount and rate of pay raise were largest for those whose career was between four years and less than six years, and smallest for those whose career was between seven years and less than nine years. The above-mentioned findings of the study suggested that in order to give dental hygienists better treatment, pay and welfare benefits should urgently be improved, and that it's required to take actions to boost their job satisfaction. Besides, they should be given more chances to receive education or to take training courses in pursuit of self-development, and how to narrow gaps in work environments among different regions or fields should carefully be considered.

• 한국문헌정보학회지
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• 제30권1호
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• pp.89-123
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• 1996

동서간의 냉전을 종식하고 탈 이데올로기 시대에 돌입한 세계정세는 체제와 이념을 극복하고 자국의 경제적 이익과 국민의 복지를 중심으로 하여 자국 우위의 경제 중심으로 변해가고 있다. 이러한 세계 정세 속에서 경쟁력을 확보하고 분단된 민족의 화합을 위하여 남북한이 통일되어야 할 것이다. 남북한이 통일되면 문명의 큰 흐름이 정보사회로 변전하는 이때에 정보를 효과적으로 수집, 가공, 축적 제공하는 제도적 장치인 도서관 정책과 제도를 어떻게 운용할 것인가 하는 과제는 국가의 중대사이다. 그런 관점에서 이 연구는 다음과 같은 결론을 얻었다. 첫째, 통일을 대비하여 민족도서관을 건설하는데 있어서 1) 정보사회형 정책과 제도 개렴 2)민족문화중심의 정책과 제도개념을 도입하는 것이 필요하다. 둘째, 통일에 앞서 우선적으로 남북한 도서관간의 협력구도를 마련하는 것이 필요하다. 이러한 협력은 종합목록의 작성, 자료의 상호대차, 자료의 공동활용을 위한 표준화된 목록규칙의 작성, 학위논문의 교환 등과 같은 실질적 이익을 가져다 주는 부분에서부터 시작해서 점차 자원을 필요로 하는 영 역으로 확산되어 야 한다. 셋째, 통일을 대비한 도서관 정책과 제도를 개발하는 일은 지배 모델로서의 통합흡수형이 아닌 상호의존 모델로서의 병존협력의 개념위에서 수행되어야 한다. 넷째, 통일을 대비한 도서관 정책원리에는 1) 자유경쟁의 논리 2) 사회교육을 통한 의식의 개혁 3) 자주의식과 인류애 4) 과학적 내지는 합리적 사고 5) 직업에 대한 소명의식 6) 민주시민정신 7) 공동체의식 8) 공익정신 9) 세계정신을 포함시킬 것이 요구된다. 다섯째, 통일을 대비한 도서관 제도모형은 남북한의 도서관이 1) 도서관의 위상통일 2) 도서관 정책 및 제도 전문연구기관의 설립 3) 전문인력의 교류 4) 정보자료의 교류 5) 학술정보망의 구축 6) 문헌정보학 교육체계의 확립과 수준향상 7) 현대화 및 정보기술 개발과 이양 등을 내용으로 갖추고 그 구체적인 사안들을 공동 개발할 필요가 있다. 끝으로 남북한의 도서관은 그 개념, 운영목적, 자원의 내용 및 이용방법 등이 모두 상이하다고 할 수 있다. 도서관의 존재이유와 그 실용성의 측면들을 고려할 때, 남북한의 도서관은 통일이라고 하는 사회적 변화에 직면하여 그 충격이 최소한의 것이 되도록 상호 공조체제를 구성할 필요가 있다.

• 지능정보연구
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• 제27권3호
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• pp.231-252
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• 2021

인공지능(Artificial Intelligence)은 미래를 가장 크게 변화시킬 핵심 동력으로 산업 전반과 개인의 일상생활에 다양한 형태로 영향을 미치고 있다. 무엇보다 활용 가능한 데이터가 증가함에 따라 더욱더 많은 기업과 개인들이 인공지능 기술을 이용하여 데이터로부터 유용한 정보를 추출하고 이를 의사결정에 활용하고 있다. 인공지능에 관한 기존 연구는 모방 가능한 업무의 자동화에 초점을 두고 있으나, 인간을 배제한 자동화는 장점 못지않게 알고리즘 편향(Algorithms bias)으로 발생되는 오류나 자율성(Autonomy)의 한계점, 그리고 일자리 대체 등 사회적 부작용을 보여주고 있다. 최근 들어, 인간지능의 강화를 위한 증강 지능 (Augmented intelligence)으로서 인간과 인공지능의 협업에 관한 연구가 주목을 받고 있으며 기업도 관심을 가지기 시작하였다. 본 연구는 의사결정을 위해 조언(Advice)을 제공하는 조언자의 유형을 인간, 인공지능, 그리고 인간과 인공지능 협업의 세 가지로 나누고, 조언자의 유형과 의사결정자의 성격 특성이 의사결정에 미치는 영향을 살펴보았다. 311명의 실험자를 대상으로 사진 속 얼굴을 보고 나이를 예측하는 업무를 진행하였으며, 연구 결과 의사결정자가 조언활용을 하려면 먼저 조언의 유용성을 높게 인지하여하는 것으로 나타났다. 또한 의사결정자의 성격 특성이 조언자 유형별로 조언의 유용성을 인지하고 조언을 활용하는 데에 미치는 영향을 살펴본 결과, 인간과 인공지능의 협업 형태인 경우 의사결정자의 성격 특성에 무관하게 조언의 유용성을 더 높게 인지하고 적극적으로 조언을 활용하는 것으로 나타났다. 인공지능 단독으로 활용될 경우에는 성격 특성 중 성실성과 외향성이 강하고 신경증이 낮은 의사결정자가 조언의 유용성을 더 높게 인지하고 조언을 활용하는 것으로 나타났다. 본 연구는 인공지능의 역할을 의사결정과 판단(Decision Making and Judgment) 연구 분야의 조언자의 역할로 보고 관련 연구를 확장하였다는데 학문적 의의가 있으며, 기업이 인공지능 활용 역량을 제고하기 위해 고려해야 할 점들을 제시하였다는데 실무적 의의가 있다.

• 대한간호학회지
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• 제3권1호
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• pp.13-40
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• 1972

Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

• Journal of Preventive Medicine and Public Health
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• 제20권1호
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• pp.165-203
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• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.